Bryony Cunningham, from SKM Enviros, discusses the emergence of health impact assessments as a theme in environmental impact assessment (EIA)
Almost every development that requires planning permission has the potential to affect human health. Some links are obvious, for example, increased road traffic or emissions to air from dust. Others are less so, such as the impact a project may have on public open spaces and the ability of the local community to exercise, with its associated health benefits. Another example is the impact of increasing traffic along residential streets, which could lead to a lack of neighbourly contact, social isolation and consequent poorer physical and mental health.
For many years the link between development and health was not considered by planning legislation and considered “not a land-use issue”. However, the Planning and Compulsory Purchase Act 2004 began to change this, with the role of planning now widened to formally take account of the environmental, social and economic impacts of developments. Recent legislative changes (including the Planning Act 2008 and the Health and Social Care Act 2012 and proposed revisions to the EIA Directive) will ensure greater consideration of health issues in the EIA process going forward.
Under the Planning Act 2008, the Health Protection Agency is a statutory consultee for nationally significant infrastructure project applications likely to involve chemicals, poisons or radiation that could potentially cause harm to people. The Centre for Radiation, Chemicals and Environmental Hazards coordinates a response to the Planning Inspectorate’s national infrastructure directorate on these issues. The centre regularly requests that health risk assessments are included within the EIA process and that hazard identification, risk assessment, mitigation and risk management are specifically addressed in the environmental statement.
The Local Government and Public Involvement in Health Act (2007) required local authorities and primary care trusts (PCTs) to produce a joint strategic needs assessment of the health and wellbeing of local communities. Needs assessment is an essential tool for informing planning and commissioning strategies. The Health and Social Care Act 2012 was subsequently implemented in April 2013, and led to abolition of PCTs and strategic health authorities. Their functions are now undertaken by health and wellbeing boards and clinical commissioning groups, with the responsibility for local population health improvement now lying with local authorities.
Examples where this has led to a change in the planning system include Halton Borough Council’s core strategy (Policy CS22), which requires that: “Applications for large scale major development are supported by a health impact assessment to enhance potential positive impacts of development and mitigate against any negative impacts.” This consideration of health within development plan policy is now resulting in assessment of health issues increasingly becoming a fundamental component of EIAs completed within the borough. With increased responsibility for public health now vested in local authorities it is likely that development plan policies will increasingly require health assessments to be carried out within the planning process.
There is an emerging body of reference material to assist EIA professionals address these issues. In the UK, the HIA Gateway (operated by the Association of Public Health Observatories) is typically the first stop for information and highlights a number of approaches, reports and methodologies, including those produced by organisations such as the Town and Country Planning Association (Reuniting health with planning), which provides guidance to planners and public health specialists.
Other valuable reference sources include:
- The Devon Health Forum for a health and well-being screening checklist
- The Merseyside Guidelines on HIA for guidance on assessment of likelihood and scale of impact
- Spatial Planning and Health Group for a checklist of issues to consider
- NHS London Healthy Urban Development Unit for guidance on issues to consider and appraisal methodology
There is a wealth of information available on approaches, methodologies and categories of health impacts although care is needed to tailor the approach to fit with the project in question.
Early engagement with health professionals in the local authority should be undertaken to ensure any preferred approaches and local issues can be reflected adequately in the assessment undertaken. However, as health becomes an area of greater formal attention in planning, more considered approaches, methodologies and more certainty and agreement on the terms used within the process will be required.
This article was written as a contribution to the EIA Quality Mark’s commitment to improving EIA practice.
Dr Bryony Cunningham is a principal consultant at SKM Enviros
